BACKGROUND: The exercise capacity of patients with thromboembolic pulmonary hypertension was investigated to clarify the long-term effects of pulmonary endarterectomy. This capacity was assessed by measuring cardiopulmonary factors during cardiopulmonary exercise testing at the maximal level of exercise and a 6-minute walk test at the submaximal level. Their survival rate was also determined. METHODS: We conducted a retrospective review of the clinical records of 102 patients who underwent pulmonary endarterectomy (63 women; median age, 53 years). RESULTS: Eight (7.8%) hospital mortalities were encountered. Three late mortalities due to fulminant hepatitis, breast cancer, and pneumonia in a patient under steroid therapy were unrelated to pulmonary endarterectomy. The actual survival rate including hospital mortalities was 90.9% at 3 years and 84.0% at 5 years. All hemodynamic measurements significantly improved and reached a plateau 1-month after endarterectomy. The cardiopulmonary exercise test at the maximal exercise level revealed that peak oxygen uptake (V(O2)) baseline was 13.8 +/- 3.2 mL/min/kg, and at 1-month was 16.2 +/- 4.2 mL/min/kg (p = 0.0015) and ventilatory response to carbon dioxide production (V(E)-V(CO2)) slope baseline was 46.5 +/- 8.4 mL/min/kg, and at 1-month was 39.9 +/- 7.4 (p = 0.0006), which gradually and significantly improved during the first year after endarterectomy (peak V(O2), 19.9 +/- 3.9 mL/min/kg [p < 0.0001] and V(E)-V(CO2) slope, 33.2 +/- 5.4 mL/min/kg [p <0.0001]). The 6-minute walk test, which reflects the systemic response at the submaximal level of functional capacity, showed that the walking distance gradually and significantly increased for up to 1 year after endarterectomy (baseline, 358 +/- 102 meters [m]; at 1-month, 433 +/- 105 m; and at 1-year, 490 +/- 80 m [p < 0.0001]) and then reached a plateau. CONCLUSIONS: After pulmonary endarterectomy, the hemodynamic recovery occurred immediately, and the patients' exercise capacity improved during the year. The 6-minute walk test was a good indicator to assess the recovery of exercise capacity.
BACKGROUND: The exercise capacity of patients with thromboembolic pulmonary hypertension was investigated to clarify the long-term effects of pulmonary endarterectomy. This capacity was assessed by measuring cardiopulmonary factors during cardiopulmonary exercise testing at the maximal level of exercise and a 6-minute walk test at the submaximal level. Their survival rate was also determined. METHODS: We conducted a retrospective review of the clinical records of 102 patients who underwent pulmonary endarterectomy (63 women; median age, 53 years). RESULTS: Eight (7.8%) hospital mortalities were encountered. Three late mortalities due to fulminant hepatitis, breast cancer, and pneumonia in a patient under steroid therapy were unrelated to pulmonary endarterectomy. The actual survival rate including hospital mortalities was 90.9% at 3 years and 84.0% at 5 years. All hemodynamic measurements significantly improved and reached a plateau 1-month after endarterectomy. The cardiopulmonary exercise test at the maximal exercise level revealed that peak oxygen uptake (V(O2)) baseline was 13.8 +/- 3.2 mL/min/kg, and at 1-month was 16.2 +/- 4.2 mL/min/kg (p = 0.0015) and ventilatory response to carbon dioxide production (V(E)-V(CO2)) slope baseline was 46.5 +/- 8.4 mL/min/kg, and at 1-month was 39.9 +/- 7.4 (p = 0.0006), which gradually and significantly improved during the first year after endarterectomy (peak V(O2), 19.9 +/- 3.9 mL/min/kg [p < 0.0001] and V(E)-V(CO2) slope, 33.2 +/- 5.4 mL/min/kg [p <0.0001]). The 6-minute walk test, which reflects the systemic response at the submaximal level of functional capacity, showed that the walking distance gradually and significantly increased for up to 1 year after endarterectomy (baseline, 358 +/- 102 meters [m]; at 1-month, 433 +/- 105 m; and at 1-year, 490 +/- 80 m [p < 0.0001]) and then reached a plateau. CONCLUSIONS: After pulmonary endarterectomy, the hemodynamic recovery occurred immediately, and the patients' exercise capacity improved during the year. The 6-minute walk test was a good indicator to assess the recovery of exercise capacity.
Authors: John E Cannon; Li Su; David G Kiely; Kathleen Page; Mark Toshner; Emilia Swietlik; Carmen Treacy; Anie Ponnaberanam; Robin Condliffe; Karen Sheares; Dolores Taboada; John Dunning; Steven Tsui; Choo Ng; Deepa Gopalan; Nicholas Screaton; Charlie Elliot; Simon Gibbs; Luke Howard; Paul Corris; James Lordan; Martin Johnson; Andrew Peacock; Robert MacKenzie-Ross; Benji Schreiber; Gerry Coghlan; Kostas Dimopoulos; Stephen J Wort; Sean Gaine; Shahin Moledina; David P Jenkins; Joanna Pepke-Zaba Journal: Circulation Date: 2016-04-06 Impact factor: 29.690
Authors: Sanjay Mehta; Doug Helmersen; Steeve Provencher; Naushad Hirani; Fraser D Rubens; Marc De Perrot; Mark Blostein; Kim Boutet; George Chandy; Carole Dennie; John Granton; Paul Hernandez; Andrew M Hirsch; Karen Laframboise; Robert D Levy; Dale Lien; Simon Martel; Gerard Shoemaker; John Swiston; Justin Weinkauf Journal: Can Respir J Date: 2010 Nov-Dec Impact factor: 2.409